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Birth defects surveillance in China
1National Center for Birth Defects Monitoring, West China Second University Hospital, Sichuan University, Chengdu 610041, China.
Insights
China
Area of Science:
- Public Health
- Epidemiology
- Pediatrics
Background:
- Birth defects pose a significant global health challenge, contributing to infant mortality and disability.
- In China, an estimated 4%-6% of newborns are affected by birth defects annually.
- A national hospital-based birth defects monitoring system has been operational for 20 years.
Observation:
- The national system monitored over 1.3 million births in 2009, representing over 8% of the national total.
- Thirty provincial surveillance programs covered more than 3.6 million births (22% of the national total).
- Significant progress has been achieved in case ascertainment, data quality, and online reporting.
Findings:
- Limitations include short ascertainment periods missing early anomalies and the need for standardized diagnostic criteria.
- Discrepancies in diagnosis between institutes can affect detection rates and introduce bias.
- Lack of baseline data and integrated databases hinder etiological studies and decision-making.
Implications:
- Effective birth defect surveillance is crucial for developing and evaluating interventions.
- Improvements are needed in national and provincial surveillance systems to better study and prevent birth defects in China.
Background:
Birth defects are a global public health problem because of their large contribution to infant mortalities and disabilities. It is estimated that 4%-6% of Chinese newborns are affected by birth defects every year. Surveillance is a basic approach to understanding the occurrence and associated factors of birth defects. The Ministry of Health of China initiated a national hospital-based birth defects monitoring system 20 years ago. Nearly every province in this country has established its own surveillance system in the past. The authors reviewed the result of the monitoring system at different administrative levels in China.
Data Sources:
Available publications on the surveillance of birth defects and data from national and provincial birth defects surveillance systems were reviewed to evaluate the effectiveness of the surveillance systems.
Results:
According to the 2009 data, the national hospital-based birth defects surveillance system monitored over 1.3 million births, which accounted for more than 8% of births in China. In addition, 30 provincial hospital-based surveillance programs covered a birth population of more than 3.6 million (22% of births in China). Great achievements have been made in terms of case ascertainment, data quality control, and online reporting. But the surveillance systems in China still have some limitations. A short ascertainment period may miss some internal anomalies, inherited metabolic diseases, and malformed fetus aborted before the 28th gestational week. Discrepancies in antenatal or postnatal diagnosis of birth defects between surveillance institutes may affect the detection rate and introduce biases. Absence of baseline data and lack of integrated database systems limit the application of surveillance data to etiological studies and affect the process of decision-making.
Conclusions:
The surveillance system for birth defects is prerequisite to propose, conduct and assess any interventions for the disease. To meet the need of study and prevention of birth defects, measures should be taken to improve the national and provincial birth defects surveillance systems in China.
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